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Boise State University Employee Information Form

  • NAME * Required
    (legal name as it appears on your social security card)
  • ADDRESS * Required
  • GENDER * Required
  • XX/XX/XXXX
  • STATUS
  • Date Format: MM slash DD slash YYYY
  • ARE YOU CURRENTLY, OR HAVE YOU EVER WORKED FOR AN IDAHO STATE AGENCY IN A BENEFIT ELIGIBLE POSITION?
  • Affirmative Action

  • Boise State University is an affirmative action employer. In order to assist us in meeting our affirmative action commitments and providing the necessary reports to federal and state agencies, we would appreciate you providing this information. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders, and regulations. Thank you for your cooperation.
  • ETHNIC GROUP HISPANIC/LATINO
    Check either yes or no. You must be a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture of origin, regardless of race.
  • WHAT RACE(S) OR CULTURE(S) DO YOU CONSIDER YOURSELF * Required
  • Veteran's Status

  • ARE YOU A US VETERAN? * Required
  • IF YOU ARE A U.S. VETERAN, PLEASE MARK ANY OF THE FOLLOWING BOXES THAT APPLY
  • Veteran's Preference: Eligibility for veteran’s preference is defined in RCW 73.16.010 as honorably discharged soldiers, sailors, and marines who are veterans of any war of the U.S., or of any military campaign for which a campaign ribbon shall have been awarded, and their widow or widowers, shall be preferred for appointment and employment. Age, loss of limb, or other physical impairment, which does not in fact incapacitate, shall not be deemed to disqualify them, provided they possess the capacity necessary to discharge the duties of the position involved: PROVIDED, that spouses of honorably discharged veterans who have a service connected permanent and total disability shall also be preferred for appointment and employment.
  • ARE YOU A MILITARY VETERAN ELIGIBLE FOR VETERAN’S PREFERENCE?
  • ARE YOU A WIDOW/WIDOWER OF A MILITARY VETERAN ELIGIBLE FOR VETERAN’S PREFERENCE?
  • ARE YOU A SPOUSE/DOMESTIC PARTNER OF AN ELIGIBLE MILITARY VETERAN WITH A SERVICE CONNECTED PERMANENT AND TOTAL DISABILITY?
  • Persons claiming veteran’s preference must provide documentation to verify eligibility such as a DD214 form.
  • Disability Status

  • DO YOU HAVE A PERMANENT PHYSICAL, SENSORY, OR MENTAL CONDITION THAT SUBSTANTIALLY LIMITS ANY OF YOUR MAJOR LIFE FUNCTIONS such as working, caring for yourself, walking, doing things with your hands, seeing, hearing, speaking, and learning? * Required
  • Note: If you mark “yes,” you will be identified as an individual who meets the affirmative action criteria for persons with disabilities.